B超引导单通道经皮肾镜气压弹道联合超声碎石术治疗肾及输尿管上段结石  

Percutaneous nephrolithotomy with pneumatic and ultrasonic power under single channel by B-type ultrasound guidance for treatment of renal and upper ureteral calculi

作　　者：熊丙建[1] 江铎[1] 唐明忠[1] 徐宝海[1] 张胜茹[1] 耿红卫[1] 雷霆[1] 张选举[1] 余义[1] 张志伟[1] 

机构地区：[1]安康市中心医院泌尿外科,陕西安康725000

出　　处：《现代泌尿外科杂志》2011年第1期61-63,共3页Journal of Modern Urology

摘　　要：目的探讨B超引导单通道经皮肾镜气压弹道联合超声碎石术治疗肾及输尿管上段结石的可行性和安全性。方法对本组258例（271侧）采用经皮肾镜气压弹道联合超声碎石清石系统（EMS III）治疗肾及输尿管上段结石的临床资料进行分析,对一期治疗效果及手术并发症进行总结。结果 271侧全部经单通道取石,手术时间30~180 min。一期单侧结石清除率84.9%（230/271）,肾结石（包括肾合并输尿管上段结石）一期清除率79.8%（154/193）。39例残余结石二期结石清除率92.3%（36/39）。输尿管上段结石一期单侧结石清除率97.4%（76/78）。无肾切除、血气胸及感染性休克并发症,迟发性出血行超选择性肾动脉栓塞2例,结肠损伤1例,中转开放2例。结论单通道经皮肾镜气压弹道联合超声碎石术治疗肾及输尿管上段结石具有手术时间短、创伤小、一期治愈率高及可经通道再次手术的优点,操作安全,疗效可靠。Objective To study the possibility and safety of curing the renal and upper ureteral calculi by percutaneous nephrolithotripsy with pneumatic and ultrasonic powers under singel channel by the guide of B-type ultrasound.Methods The clinical data of 258 cases（271 sides） were treated by percutaneous nephrolithotripsy of using pneumatic and ultrasonic system（EMS III） carryed on analysis,the curing effect and surgical operation carryed on summary.Results All cases were performed with single channel,surgical operation time 30~180 mins.Single side first calculi clearance leaded 84.9%（230/271）,renal calculi（include renal merger upper ureteral calculi） clearance leaded 79.8%（154/193）.39 remaining calcului second clearance leaded 92.3%（36/39）.Single side upper ureteral calculi first clearance leaded 97.4%（76/78）.No nephrectomyhem、opneumothorax and septic shock.2 cases with delayed hemorrhage were cured by selectivity thrombosis of renal artery,the colon hurted a,turned to open 2.Conclusions Percutaneous nephrolithotrpsy with pneumatic and ultrasonic powers under single channel treating the renal and upper ureteral calculi have operation time shorter and small wound,successive rate higher and have the advantage of operation through passage again,safety of operation and reliable efficacy.

关 键 词：肾及输尿管上段结石 经皮肾镜 气压弹道及超声碎石术 超声引导 

分 类 号：R692.4[医药卫生—泌尿科学] R693.4[医药卫生—外科学]